颈椎单开门椎管扩大成形术OsteoMed M3钉板固定的疗效

The clinical effects of expansive unilateral open-door laminoplasty of the cervical spine with OsteoMed M3 plate and screws fixation

目的总结颈椎单开门椎管扩大成形术中OsteoMed M3钉板内固定的效果。方法回顾性分析2007年10月至2011年2月汕头大学医学院附属粤北人民医院收治的20例颈椎病患者的临床资料,患者行颈椎单开门椎管扩大成形术并应用OsteoMed M3钉板固定;术后1周、12个月测量椎板开门角度和纤维性椎管矢状径(FSD),计算开门角度增加率和丢失率;术后3、12个月进行JOA评分并计算改善率;观察术后12个月轴性症状分级并计算其发生率。结果 20例患者均顺利完成手术,未出现神经损伤、伤口感染等并发症。术后平均随访时间17.3个月。术后1周开门角度及FSD均明显较术前增加(P<0.05);术后12个月开门角度及FSD较术后1周有所降低,但仍明显高于术前(P<0.05)。术后3、12个月JOA评分分别为(8.4±1.8)分、(11.0±2.4)分,与术前的(5.5±2.0)分比较,差异有统计学意义(P<0.05);术后3、12个月JOA改善率分别为(25±16)%、(48±22)%。术后12个月,5例(25%)患者出现轴性症状,其中可3例、差2例,经治疗后4例缓解、1例缓解不明显。结论 OsteoMed M3钉板系统操作安全简单,可保证脊柱的稳定性。

Objective To evaluate the clinical effects of OsteoMed M3 titanium plate and expansive unilateral open-door laminoplasty of the cervical spine. Methods From October screws 2007 to fixation in February 2011, 20 patients with cervical spondylosis were treated by expansive unilateral open-door laminoplasty using OsteoMed M3 plate and screws fixation at Yuebei People＇s Hospital Affiliated to Shantou University Medical College. The lamina open angle and fibrous sagittal diameter （FSD） were measured at l week and 12 months after operation, and the increase rate and loss rate of open angle were calculated. The Japanese Orthopaedic Association （JOA） scoring was applied to evaluate at calculated. Axial symptom （AS） was graded 12 mon 37 ths 12 months after operation, and JOA recovery rate was after operation, at the same time, the incidence was recorded. Results Twenty patients received successful operations. No injuries of nerves or wound infection occurred. The average follow up time was 17.3 months. Compared with the preoperation, the lamina open angle and FSD increased 1 month, 12 months after operation （P 〈0.05）. The preoperative JOA score was 5.5 ~ 2.0, while JOA score at 3 and 12 months after operation were 8.4 ±1.8 and 11.0 ±2.4 respectively, the difference between pre- and postoperative JOA score had statistical significance （P 〈0.05）; JOA recovery rate at 3 and 12 months after operation was （25 ± 16）% and （48 ± 22）% respectively. Five patients suffered AS at 12 months after operation, in which 3 patients were fair and 2 inferior. Conclusion Unilateral open-door laminoplasty with OsteoMed M3 titanium plate and screws system fixation is a simple, safe method which can preserve the spinal stability.